[Multidisciplinary treatment of primary cancer of the breast]

The prognosis of surgery for carcinoma of the breast is directly and closely related with the number of homolateral axillary lymph nodes involved. When node involvement is present, recurrences are numerous and early, this tendency being increased in accordance with the number involved. When 4 or more nodes are involved, 35 to 52% of recurrences are seen during the first 18 months, according to the differend statistics available. Such recurrences are distant in 85% of cases. This is due to the fact that carcinoma of the breast, even in its early stages, is most often a generalised disease with disseminated lesions in the form of distant micrometastases. In these cases with a poor prognosis, some form of treatment to complement surgery is necessary. Radiotherapy has proved a failure, useless and often harmful as a result of prolonged reduction in cellular immune defences. Prolonged polychemotherapy, by contrast, has shown its great, not to say astonishing, effectiveness. Continued study is thus essential.